Booby Traps Series: Booby Traps in the Dentist’s Chair

“I have to have some dental work done next week, and they will be using local anesthesia. When I called to schedule the appointment they asked if I was nursing, and when I said yes the dentist recommended that I not breastfeed for one day after the appointment!” – Recent post on a La Leche League forum

Few of us relish going to the dentist, but comments like these show just how stressful it can be to be a nursing mom in the dentist’s chair.

Here are some fairly common Booby Traps moms encounter at the dentist’s office:

“I’m going to give you this local anesthetic, so you’ll need to pump and dump for ___ hours.”

Pain medications such as lidocaine are compatible with breastfeeding, and there’s no need to interrupt breastfeeding, in spite of what the mother quoted above was told.

“We’ll be using laughing gas, so you’ll need to pump and dump.”

According to Dr. Thomas Hale (author of Medications and Mother’s Milk), “nitrous oxide is “rapidly eliminated from the body due to rapid exchange with nitrogen via the pulmonary alveoli (within minutes). A rapid recovery generally occurs within 3-5 minutes… Ingestion of nitrous oxide orally via milk is unlikely.”

“Breastfeeding? It causes dental caries, especially if you do it for a long time.”

Breastfeeding isn’t associated with dental caries, a recent study shows. As the American Dental Association concludes: “A new study in the October 2007 Pediatrics should help to reassure nursing and expectant mothers, as well as pediatric dentists, since it found that neither breastfeeding nor its duration is associated with increased risk of early childhood caries.”

“Unrestricted nursing at night causes dental caries.”

This is more complicated, as the American Dental Association does currently state, “Unrestricted, at-will nocturnal breastfeeding after eruption of the child’s first tooth can lead to an increased risk of caries.” [The Canadian Dental Association is more measured in its statement: “Unrestricted at-will breast-feeding at night may increase the risk of tooth decay, although the majority of breast-fed children do not experience this early childhood disease.”]

There are a number of differences between night breastfeeding and letting a baby go to bed with a bottle, which is known to cause caries. The mechanics of breastfeeding are different from bottle feeding. As this well-researched article from La Leche League points out, when a baby is breastfeeding milk enters the baby’s mouth very near the throat, so it is far less likely to “pool’ in the baby’s mouth as happens when a baby falls asleep with a bottle. Second, some components of breastmilk may be protective against bacteria that cause decay. Finally, research has not found an association between breastfeeding and caries.

“Want to whiten your teeth? You can’t do that while you’re breastfeeding.”

Earlier this year I had my teeth whitened in my dentist’s office, and when I signed the consent form I noticed that there was a warning saying that it wasn’t advised for (pregnant and) nursing women. I brought it up with my dentist he chalked it up to covering one’s behind. But I’ve seen moms on various forums report that their dentists recommended against it while breastfeeding. Teeth whitening is safe during breastfeeding, says Dr. Thomas Hale in Medications and Mother’s Milk: “it would be all but impossible for any [peroxide] to reach breastmilk except under extreme overdose.”

“You’re nursing? Oh.”

Finally, I know that this is asking a lot, but I’ve never once heard a dentist say, “Hey, that’s great that you’re breastfeeding! It’s really great for preventing tooth decay, for the development of your baby’s palate, for teeth alignment, and general oral health.” That’s what the evidence supports, but instead of congratulations I only hear objections and warnings.

Did you encounter any Booby Traps in the dentist chair? How did it impact your breastfeeding experience?

My gums aren’t great (I’m working with better brushing technique and trying some natural remedies as well), and every time I go in they look at my chart and say “oh, you’re breastfeeding? Sometimes the hormone changes of pregnancy and breastfeeding can affect your gums/oral health….we’ll see if this gets any better after you’re done breastfeeding.” I always just smile and nod. I don’t think they’re anti-breastfeeding necessarily, but I am afraid to say “I’ve been breastfeeding for the last 3.5 years [two kids] and plan to be breastfeeding for quite some time yet…what else can we do now while I’m still breastfeeding to keep these gum issues from getting worse”.

Yes! I feel guilt every time they bring up my gum recession. I’ve also been pregnant, nursing, nursing while pregnant, now nursing again for the past few years. What natural remedies are you using? I had a graft from my roof of my mouth to my gums in 2009 so thankfully those have staid the same rather than receed. I did tell the dentist that I have a six month old and two year old after she went on an on about my gums. Good times!!

Not from my own dentist, but I haven’t needed anything beyond a cleaning while pregnant or nursing.

Our daughter’s pediatric dentist was totally non-judgmental about the fact that she was still breastfeeding when she had her first dental visit at 17 months old – neither she or the hygienist batted an eye and both said it was wonderful that she was nursing. The dentist immediately spotted a rather substantial upper lip tie which we didn’t know she had until that time; she expressed some surprise that I’d been able to exclusively breastfeed in light of the lip tie. I was just happy to finally have an explanation for why she never outgrew her shallow latch and slow milk transfer! At her 2nd visit at 23 months it was more of the same positive attitude regarding breastfeeding (our daughter self-weaned shortly after her 2nd birthday).

I had a great experience at the dentist. I breast fed my son while getting a cleaning. The woman doing the cleaning said she was amazed at how wonderful the female body is. She said the only thing I couldn’t do was get my teeth bleached.

I am a dental hygienist and a lactation counselor. This was an interesting post. I have had many discussions with my dentist about night breastfeeding and early childhood caries. I chose to breastfeed through the night with my son, and plan on doing the same with my daughter. My son’s teeth are free of decay. I do recommend to my patients to wipe the teeth/gums after a feeding when possible.

Regarding “We’ll be using laughing gas, so you’ll need to pump and dump.”

REALLY?? Can’t believe ANYONE who’s been through either dental or medical school would believe let alone say this since nitrous oxide is very commonly given during labor.

And peroxide used in teeth whitening?? That is just so ignorant. If you’re going to warn against the use of peroxide, better warn against the use of household cleaners too. The chemicals in question have about as much effect on a breastfeeding child.

I had an oral surgeon try to tell me it was not safe to take Motrin but instead wanted me to take 4 x 10mg Flexeril tablets a day. When I tried to explain that she was incorrect she got irritated with me and left. I called to confirm my suspicions with my daughter’s pediatrician and they agreed that the oral surgeon was just plain ignorant. I called back to her office and her receptionist kept sending my calls to voicemail! I ended up calling from a different number and they answered! I informed the Dr. that its dangerous for her to be giving outdated and incorrect information to nursing mothers but again she got defensive and hung up on me lol.

I am a dentist. I’m pregnant with my second child now. My first child I breastfed until he was about 11 months old. I am a breastfeeding advocate however I don’t feel it’s entirely appropriate for someone to feed while having work done in the dental chair. My only thoughts are for safety as we use sharp instruments and are actually performing a procedure while you sit in the chair. The mother can have involuntary reactions- pain etc… And in proximity to dental equipment it’s just plain old not safe! For this reason I wouldn’t breast feed in a dental chair or other similar medical situations. Please know this article really doesn’t represent most dentists- we are trained on what you can and can’t give someone that is pregnant or breast feeding. I would like to think it very rare to see any of the aforementioned “booby traps” in the article. Congratulations to you breast feeding mothers out there- being a mummy is hard work, being a dentist is too though (and being both- well life is never dull)